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Posted By Maria on 02-21-2019, 14:55:17 in Ob-Gyn
Hello Melanie,

I see a lot of pregnant patients showing up in L&D with no compliant.

They have been in a slow moving MVA, older child ran into their tummy, hit their belly on the cabinet door, fell over dog, fell over toy, etc...

But nothing hurts, just worried well.

The patient is monitored around 4 hours, and usually discharged with appropriate warning sign to look for.

What would be the primary ICD 10 code?

O9A.21x
Injury, poisoning and certain other consequences of external causes complicating pregnancy, childbirth and the puerperium) ??

I always use the V and Y code to describe what happened and where, but am at a loss for worried well for OB,

Thanks, Maria

Comments (1)
Posted By Melanie Witt on 02-21-2019, 15:26:28
I would follow the guidelines in this case: There are three observation Z code categories. They are for use in very limited circumstances when a person is being observed for a suspected condition that is ruled out. The observation codes are not for use if an injury or illness or any signs or symptoms related to the suspected condition are present. In such cases the diagnosis/symptom code is used with the corresponding external cause code.

This rule goes on to say: Codes from subcategory Z03.7, Encounter for suspected maternal and fetal conditions ruled out, may either be used as a first-listed or as an additional code assignment depending on the case. They are for use in very limited circumstances on a maternal record when an encounter is for a suspected maternal or fetal condition that is ruled out during that encounter (for example, a maternal or fetal condition may be suspected due to an abnormal test result). These codes should not be used when the condition is confirmed. In those cases, the confirmed condition should be coded. In addition, these codes are not for use if an illness or any signs or symptoms related to the suspected condition or problem are present. In such cases the diagnosis/symptom code is used. Additional codes may be used in addition to the code from subcategory Z03.7_, but only if they are unrelated to the suspected condition being evaluated. For encounters for suspected fetal condition that are inconclusive following testing and evaluation, assign the appropriate code from category O35, O36, O40 or O41.

For the things you listed above, the most likely code would be Z03.79,
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